Many of the men who participated said they wanted to avoid the stigma and homophobia they felt certain would lead to strong negative emotional reactions and profound changes in their relationships.

Eric W Schrimshaw, associate professor of Sociomedical Sciences at Columbia University’s Mailman School of Public Health, said: “Our results clearly identify the need for public education campaigns to dispel myths about bisexual men – that bisexual men are not gay, do not have HIV, and are not necessarily non-monogamous.

“The anticipated negative reactions from female partners suggest the need for strategies to assist behaviourally bisexual men disclose their sexual history in ways that minimise negative reactions and work with the couple to preserve the relationship”, he said.

The report found the men did not report a heterosexual identity, identity uncertainty, or other identity issues as reasons for non-disclosure. This was instead linked to wanting to avoid anticipated responses such as “ridicule, rejection, and victimisation”.

Earlier research suggested that high levels of emotional distress among behaviourally bisexual men are a result of concealment of their sexual orientation. “The current findings provide new insights into why non-disclosure could result in greater emotional distress”, said Schrimshaw, who led the research.